Provider Demographics
NPI:1912100462
Name:JILL R. FRIEDMAN & ASSOCIATES
Entity Type:Organization
Organization Name:JILL R. FRIEDMAN & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:R
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CRRN, CDMS, CCM
Authorized Official - Phone:907-344-8820
Mailing Address - Street 1:9330 VANGUARD DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-5393
Mailing Address - Country:US
Mailing Address - Phone:907-344-8820
Mailing Address - Fax:907-344-9088
Practice Address - Street 1:9330 VANGUARD DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-5393
Practice Address - Country:US
Practice Address - Phone:907-344-8820
Practice Address - Fax:907-344-9088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKHC7723Medicaid